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New Congenital Hypothyroidism Screening Information

In response to recent budget reductions, Arizona’s Newborn Screening (NBS) Program will shortly be changing our laboratory method for the detection of Congenital Hypothyroidism (CH) in newborns by bloodspot. Effective May 1, 2009, screening results will be reported to you for thyroid stimulating hormone (TSH) only instead of thyroxine (T4) with a TSH backup. This decision was arrived at with the advice and agreement of our consulting pediatric endocrinologists and we believe that this new method will improve the accuracy and reliability of the determination of CH in newborns while significantly reducing analytical costs and false positives.

There are two widely used screening strategies for the detection of congenital hypothyroidism: a primary TSH/backup T4 method and a primary T4/backup TSH method. Since the diagnosis of primary hypothyroidism requires an elevated TSH, most programs in Europe, Japan, Canada, Mexico, and the United States screen by using primary TSH measurements. It should be noted that programs that use TSH only do not detect infants with low levels of T4 related to prematurity or TBG deficiency, neither of which require treatment, nor do they detect secondary (pituitary) or tertiary (hypothalamic) forms of hypothyroidism. The latter, whose incidence is estimated at 1:100,000 compared to 1:2000 – 1:4000 for primary congenital hypothyroidism, are often accompanied by other findings (e.g. hypoglycemia, mid-line defects, etc.).¹

We will continue to communicate with you as we make changes to our testing and follow-up protocols for the other inherited disorders screened by our program. If you have any questions related to this laboratory change, please do not hesitate to contact either Dr. Sundin Applegate, NBS Medical Director, at applegs@azdhs.gov or (602) 542-1223 or Ward Jacox, NBS Office Chief at jacoxw@azdhs.gov or (602) 364-1410. If you have clinical questions, please contact one the consulting pediatric endocrinologists listed below.

¹
Update of Newborn Screening and Therapy for Congenital Hypothyroidism. American Academy of Pediatrics, Susan R. Rose, and the Section on Endocrinology and Committee on Genetics, American Thyroid Association, Rosalind S. Brown, and the Public Health Committee and Lawson Wilkins Pediatric Endocrine Society PEDIATRICS Volume 117, Number 6, June 2006

Blood Specimens

Order our brochures [PDF 24K] for hospitals and providers. 

Order blood specimen collection kits [PDF 8K] for hospitals and providers.

View a presentation about proper collection [PDF601K]

Print a poster describing proper collection [PDF 372K]

Print a poster describing common collection mistakes [PDF 212K]

Disorder Act Sheets (What to Do)

Human Genetics and Medical Research Information about understanding genetic diseases, DNA, genes, and chromosomes. 

Mountain States Genetics Regional Collaborative Center Also includes additional links to parent resources.  Also includes additional links to parent resources.  
  
Sickle Cell Trait: Answers to Commonly Asked Questions [PDF 64K]

Parent Refusal Form [PDF16K]

Cystic Fibrosis Screening Process with Mutations [PDF 24K]


Hearing  

A Family's Checklist: Infant Hearing (English/Spanish) [PDF 60K]

Top 10 Strategies to Minimize Loss to Follow-up [PDF 172K]

Joint Commission on Infant Hearing (JCIH) 2007 Position Statement [PDF 756K]

View the Administrative Code (aka Rules) for hearing screening web site

Statewide Testing Contacts [PDF 552K] 

AAP Medical Home Guidelines [PDF 891K]


View Larger Map Screening and Diagnostic Resources [PDF 520K] 

Map of Screening & Diagnostic Resources [PDF 700K]

National Center for Hearing Assessment and Management (NCHAM)

Hospital Guidelines [PDF148K]

History of Arizona Hearing Screening [PDF 600K]

Arizona Hands & Voices brochure: parent support group [PDF 1.24K]

Explanation of Hearing Test: Arabic, Chinese, French, Hindi, Japanese, Korean, Portuguese, Russian, Somali, Spanish, Ukrainian, Vietnamese

Explanation of Hearing Loss: Chinese, French, Hindi, Japanese, Korean, Russian, Somali, Spanish, Ukrainian

CDC Early Hearing Detection and Intervention (EHDI)  

Hear and Now

My Baby's Hearing - Boy's Town National Research Hospital

American Academy of Pediatrics (AAP) Newborn and Infant Hearing Screening Activities

The EAR Foundation of Arizona 

Hear for Kids: loaned hearing aids [PDF 96K] 


Newborn Screening Program Publications:

Newborn Screening: A guide for parents (English/Spanish) [PDF 168K]

Arizona Hospitals Newborn Hearing Screening Guidelines [PDF 194K]